Residential Care and Assisted Living Compendium: 2007. Massachusetts

11/30/2007

[A PDF [http://aspe.hhs.gov/daltcp/reports/2007/07alcomMA.pdf] of only this state's summary also available]

Citation

Assisted living: 651 CMR 12.00 et seq.
Residential care facility Level IV (rest homes): 105 CMS 150.000 et. seq.

General Approach and Recent Developments

Further revisions to the regulations were issued in 2006. A consumer guide was prepared and is available at http://www.mass.gov/Eelders/docs/assisted_consumer_guide.pdf.

The revised rules include a purpose section that describes the state’s philosophy: “The purpose of these regulations is to promote the availability of services for elderly or disabled persons in a residential environment; to promote the dignity, individuality, privacy and decision making ability of such persons and to provide for their health, safety, and welfare; and to promote continued improvement of ALRs.” To be certified, residences must submit information such as the number of units and number of residents per unit, location of units, common spaces, and egress by floor; base fees to be charged; services to be offered and arrangement for delivering care; number of staff to be employed; and other information required by the Executive Office of Elder Affairs. The buildings are considered residential use for applying appropriate building codes.

Adult Foster Care

AFC is a covered as a Medicaid state plan service and is regulated by the MassHealth (Medicaid) program. Regulations are available at: http://www.mass.gov/Eeohhs2/docs/masshealth/regs_provider/regs_adultfostercare.txt.

Web Address Content
http://www.mass.gov/?pageID=eldersterminal&L=3&L0=Home&L1=Regulations+and+Statistics &L2=Housing+%2f+Assisted+Living&sid=Eelders&b=terminalcontent& f=reg_651cmr12_final&csid=Eelders   Rules, Q&A, incident report  
http://170.63.97.68/portal/site/massgovportal/menuitem.db805ceae7e631c14db4a11030468a0c/ ?pageID=elderssubtopic&L=3&L0=Home&L1=Housing&L2=Assisted+Living&sid=Eelders Consumer, list, guide

 

Supply
Category 2007 Areas Scored Threshold
1: ADLs (A) Bed mobility, transfers, toilet use; and
(B) eating.
Score of 6:
(A) independent or supervision, 1; limited assistance, 3; extensive or total, 4; did not occur, 8.
(B) independent/supervision, 1; limited assistance, 2; extensive or total, 3; did not occur, 8.
2: Cognitive performance Short-term memory, cognitive skills for daily decision making, communication. Must have severely impaired decision making, memory problems and moderate or severely impaired decision making, or memory problem and sometimes or rarely understood.
3: Physician involvement Under care for an unstable medical condition. Based on frequency of physician visits and orders.
4: Treatments and conditions Stage III or IV pressure sores; IV or parenteral feedings; IV medications; end-stage care; daily trach care, respiratory care, or suctioning; pneumonia; daily oxygen therapy; daily insulin with 2 order changes in past 14 days; peritoneal or hemodialysis. At least 1 of 9 conditions.
5: Skilled rehabilitation therapies Speech, occupational, or physical therapy. Requires at least 45 minutes of active therapy in last 7 days and continues to require therapy.
6: Behavior Wandering, physical/verbal abuse, socially inappropriate/disruptive, resists care, delusions/hallucinations. Either has delusions/hallucinations or exhibits other behaviors at least 4 of last 7 days.
7: Service dependency Currently receiving services in a nursing facility or waiver program. Must be a participant for 1 year.

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